Search form

Search form

Aggressive pharmacy benefit plan design that increased generic substitution held the growth in Medicare Part D drug prices to 0.5% annually from 2006 to 2010, according to a Medicare Payment Advisory Commission report.

Related Summaries

The Medicare Payment Advisory Commission said it is concerned that fee-for-service physician payments undervalue primary care and overvalue specialty care. MedPAC's annual report called on Congress to increase 2017 payment rates for physicians as the law requires and noted the growth rate for primary care physicians is keeping pace with the Medicare population.

Most Medicare prescription drug plans cover prescriptions obtained at 95% of the pharmacies in the plans' regions, and about a third of those pharmacies are designated as preferred, according to a report from the Medicare Payment Advisory Commission. Some 75% of seniors choose plans with preferred networks, notes industry expert Adam Fein. A now-withdrawn CMS proposal "would have effectively killed preferred pharmacy networks," Fein writes, and the MedPAC report includes suggestions that address the CMS' concerns.

A Medicare Payment Advisory Commission report to Congress said readmission penalties for hospitals that treat high numbers of poor patients are too harsh. The commission recommended Medicare change the formula so that it compares readmission rates among hospitals with similar numbers of poor patients.

The Medicare Payment Advisory Commission recommends that doctors who order more advanced imaging tests than their peers be required to obtain preauthorization. The panel also said the CMS should reduce fees for successive imaging tests conducted in one imaging session.